- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,512.10 / $21,122.50 / $37,169.50
| Facility | | $12,512.10 | $21,122.50 | $37,169.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,434.05 / $43,447.54 / $72,046.77
| Facility | | $29,434.05 | $43,447.54 | $72,046.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,381.71 / $19,321.71 / $26,884.28
| Facility | | $11,381.71 | $19,321.71 | $26,884.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,078.40 / $43,078.40 / $50,556.16
| Facility | | $43,078.40 | $43,078.40 | $50,556.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $18,408.07 / $26,293.83
| Facility | | $1,787.00 | $18,408.07 | $26,293.83 |